Medicare Cold Call Scenarios

[glrocky]

I've just received 100 turning 65 leads. Could the Medicare gurus in attendance please pass judgement on 2 prospecting scenarios that I am considering:

(1) Knock on their door and -- after some chit chat about how confusing Medicare is to someone turning 65 - tell them that I want to discuss their Medicare Supplement options with them. Before I set the appointment, though, I will tell them that in order to give them a balanced overview of their Medicare options, that I will need to discuss the Medicare Advantage program. In order to discuss the MA program, though, I will need to get their written consent (Scope of Appointment). I will then go ahead and schedule the appointment a minimum of 48 hours in advance.

(2) Knock on their door and -- after some chit chat about how confusing Medicare is to someone turning 65 - tell them that I want to discuss their Medicare Supplement options with them. After having discussed Medicare Parts A & B and the supplement, I will tell them that in order to give them a balanced overview of their Medicare options, that I will need to discuss the Medicare Advantage program. In order to discuss the MA program, though, I will need to get their written consent (Scope of Appointment). I will then go ahead and schedule the appointment a minimum of 48 hours in advance.

Assume that the carrier that I discuss has both MA and Supplement plans.

What are your thoughts as to the legality of either scenario?

 

[Josh]

That's 100% illegitimate the way you've described it. The key here is that you are bringing up the MA. If you're talking about Med supps and then they ask about the MA, you can then have them sign a SOA form and roll into a presentation right then and there. That being said, it's a horrible business plan. Some states are seeing the situation for what it is and unless you're promoting the Med supps and legitimately trying to sell them and ONLY selling MA occasionally and as people ask for it, you're setting yourself up for some uncomfortable conversations with the powers that be. A small agency in NY was fined over $110,000 for doing what your describing.

If your goal is to sell Medicare Advantage then do not do any cold calling or door knocking as a way of generating business. The language of the law is very specific and there really isn't much of a gray area. The best thing you can do is try to sell Medicare supplements and make that your focus. If you're going to sell MA, then you need to find other ways to market.

 

[jdeasy]

I've just received 100 turning 65 leads. Could the Medicare gurus in attendance please pass judgement on 2 prospecting scenarios that I am considering:

(1) Knock on their door and -- after some chit chat about how confusing Medicare is to someone turning 65 - tell them that I want to discuss their Medicare Supplement options with them. Before I set the appointment, though, I will tell them that in order to give them a balanced overview of their Medicare options, that I will need to discuss the Medicare Advantage program. In order to discuss the MA program, though, I will need to get their written consent (Scope of Appointment). I will then go ahead and schedule the appointment a minimum of 48 hours in advance.

(2) Knock on their door and -- after some chit chat about how confusing Medicare is to someone turning 65 - tell them that I want to discuss their Medicare Supplement options with them. After having discussed Medicare Parts A & B and the supplement, I will tell them that in order to give them a balanced overview of their Medicare options, that I will need to discuss the Medicare Advantage program. In order to discuss the MA program, though, I will need to get their written consent (Scope of Appointment). I will then go ahead and schedule the appointment a minimum of 48 hours in advance.

Assume that the carrier that I discuss has both MA and Supplement plans.

What are your thoughts as to the legality of either scenario?

Do not under any circumstance cold call or door knock to discuss MA and/or PDP. Do not use med sups as your guise to get around those restrictions. Door knock or cold all you want to sell med sups or FE. When you enter MA and PDP's into the mix, you are violating MIPPA regulations and you will get caught. Maybe not at first, but, when someone has a problem with their MA plan or their PDP, they will come clean with how they got enrolled.

 

[glrocky]

Understood. When you get the inevitable "it's too expensive" response, though, how would you transition to a discussion - however slight - of other Medicare options? Mipaa rules don't allow you to discuss an MA option without them having inquired about it first.

 

[Josh]

Understood. When you get the inevitable "it's too expensive" response, though, how would you transition to a discussion - however slight - of other Medicare options? Mipaa rules don't allow you to discuss an MA option without them having inquired about it first.

That is exactly the wrong type of conversation to be initiating by a door knock or cold call. This is one of the few times where JD and I will totally agree, if you're goal is to sell MA then find another way to market. If you get the response "it's too expensive" then according to some compliance officers you can transition to MA if they ask for "something else". But if you're door knocking hoping that people will say it's too expensive so that you can sell them MA then you're asking for trouble you don't want. If you're going to solicit for Med supps, then you should plan on selling Med supps, not find ways to sell MA.

 

[glrocky]

MedicarePlanSolutions, I apologize in advance if I have misinterpreted what you said. I hope you didn't assume that I was having a long drawn out discussion about Medicare at their door. The scenario that I referred to occurred at the end of a future appointment. I simply set the appointment at the door.

My intention is to sell Medigaps, but the list that I obtained from several carriers did not contain telephone numbers, nor was it qualified by income. This is Southern California. The majority of the seniors here are enrolled in MAPD plans. They are sensitized to price. It's also likely that my list doesen't contain the right demographics for potential MedSupp clients.

Assuming that I've done everything in my power to sell a MedSupp and price becomes the ultimate sticking point, would you recommend anything beyond simply walking out the door?

 

[Tom Highway]

Let's say you do this door knocking and make a sale. Whoever you submit the business through may or may not ask for more details, but CMS can audit a sale and ask for details about how you initially contacted this person.

If you are truthful and say you door knocked to talk about med supps, but the beneficiary brought up MAPD, your butt may still be in a sling. Even before MIPAA, door knocking was one of the things that was strictly prohibited, and if you're door knocking for something else results in a MA sale, it's just too risky.

What you could do is cold call for med supps, but make sure you record the conversations. ONLY if someone, without you prompting them, asks about MA, would I proceed with MA, and you should keep that recording forever!!

I may be wrong, but violations COULD result in some steep fines and even jail time for the agent. It's just not worth it.

 

[captain94]

Its all insane. I cold call as my main source of marketing (on the phone not at the door) I sell 95% Med-supps. but even on the med-supp appointment they ask me about Part D and Part C. I have them sign the SOA and continue. Im not looking to sell the MA, Far from it just trying to answer the questions that are asked and give them the best advice for there situation. Am I in violation of the MA rules? I look at it that if im ALWAYS doing the right thing for the client I should be fine. but I dont want CMS breathing down my neck ready to fine me for trying to due the right thing and help a T65 understand their options..

 

[jmhopkins40]

Let's say you do this door knocking and make a sale. Whoever you submit the business through may or may not ask for more details, but CMS can audit a sale and ask for details about how you initially contacted this person.

If you are truthful and say you door knocked to talk about med supps, but the beneficiary brought up MAPD, your butt may still be in a sling. Even before MIPAA, door knocking was one of the things that was strictly prohibited, and if you're door knocking for something else results in a MA sale, it's just too risky.

What you could do is cold call for med supps, but make sure you record the conversations. ONLY if someone, without you prompting them, asks about MA, would I proceed with MA, and you should keep that recording forever!!

I may be wrong, but violations COULD result in some steep fines and even jail time for the agent. It's just not worth it.

you really didnt just tell another agent to record a conversation with out the clients knowledge...did you?

 

[bourbonlegend]

"turning 65s" will always know more about medicare supplements and medicare advantage than even the most seasoned agent. I suggest that instead of pitching these people you go in looking for their advice. Kindly thank them for sharing their opinions and expertise then move onto the 67+ market to share what you've learned from these folks.